Diagnostic Criteria:
http://www.sjogrens.org/home/about-sjogrens-syndrome/healthcare-providers/diagnosis-criteria
http://www.pennmedicine.org/rheumatology/presby/sjogrens/hi_diag.html
http://www.hopkins-arthritis.org/physician-corner/education/acr/acr.html#sjogrens
http://www.medicalcriteria.com/site/index.php?option=com_content&view=article&id=211%3Areusjs&catid=79%3Arheumatology&Itemid=80&lang=en
Each of these requires EITHER positive histology on labial gland or parotid gland biopsy, OR the presence of +ANA, with or without +SSA or SSB. Hopkins is more liberal in that they do not require +SSA/SSB, only a +ANA.
In order to study a disease, it MUST be defined. From what I can read from credible institutions, the diagnosis of Sjogren's is not made unless the biopsy is + and or the serology is +. It appears that how significant the sicca is, they don't care. They don't call it Sjogren's.
Your findings are correct...these are the exact definitions at the new Johns Hopkins Sjogren's Center. They will NOT see you unless you fulfill their criteria. If you don't have positive SSA or SSB, you must have a positive schirmer's AND positive lip biopsy.
You have to provide that lip biopsy (actual slides) before you even make an appt. If you have other documentation (like + schirmer's) they will likely ask for the lip biopsy while you await your first appt. Doctors review documentation before appt's made to weed out the "sicca" vs Sjogren's patients, since they are overwhelmed with new patients.
http://www.hopkinsmedicine.org/rheumatology/clinics/sjogrens-center.html
I'm not saying I agree or disagree. I think there is much to be learned yet in the diagnostics of Sjogren's, PN, and other A1 diseases.
I don't disagree or agree either. I am ambivalent. The thing is, there has to be defined criteria.
I did go to Hopkins, and had to send my slide even with a +ANA.
I think it is important for people to realize, even if Sjogren's is a dead end, there IS a diagnosis for them. I am not one to tell people to latch onto the first one that comes their way either. Diagnosis of AI disease can be a very, very long process.
I know we have an almost identical clinical course, other than the ANA....but you are younger...